4.9 Outbreak response committees


Outbreak response committees (or crisis cells) are formed at the national, regional and/or district level depending on the extent of the outbreak and health system structure. These committees coordinate the outbreak response at their respective levels.

The committees meet on a regular basis: daily at the start of the outbreak, and then weekly until operations are over. The meetings are short and have clear agendas.

The minutes are distributed to managers at each level and to the partners. Feedback can also be given via a weekly report relaying the essential information.

4.9.1 Composition of the committees

At each level, the committee is composed of representatives from:
– Ministry of Health;
– Hospitals, cholera treatment structures;
– Water and sanitation services;
– Administrative authorities;
– Support agencies (WHO, UNICEF, bilateral cooperation) and non-governmental organizations.

Outbreak response requires close coordination with other sectors, which may participate in specific meetings on an as-needed basis. These sectors include:
– Laboratories;
– Media: radio, newspapers and television disseminate information on the existence of an outbreak, the symptoms of the disease, treatment locations, free care, etc.;
– Customs: can facilitate the importation of drugs and equipment;
– Public safety: the police can help maintain order during large mass vaccination campaigns.

4.9.2 Role of committees

The Terms of Reference (responsibilities and decision-making level) are drawn up on a case-by-case basis.

National committee

The national committee defines the strategy for surveillance, patient management, vaccination, public information and health promotion. It must provide appropriate solutions for the implementation of outbreak response (Table 4.4).
The national committee defines roles and responsibilities of descending-level committees (region, district). It also supervises activities, mobilizes the necessary resources, and coordinates and informs partners at the national level.
As evaluation is a component of any operation, the committee must ensure regular reviews of implementation. The aim is to improve operations by formulating recommendations with regard to what is being done in practice.

Table 4.4 - Objectives and key responsibilities of the national committee


Objectives

Responsibilities

Epidemiological surveillance

  • To provide daily or weekly data for decision-making.
  • To define the priority areas for interventions.
  • Select and diffuse a standard case definition.
  • Strengthen or establish a simple, regular and reliable data collection and analysis system.

Patient management

  • To shorten the time between the first symptoms of cholera and treatment.
  • To reduce the CFR.
  • To make free treatment available at all times and at all levels.
  • Define and diffuse treatment protocols.
  • Assess needs in terms of:
    • cholera facilities;
    • treatment supplies;
    • staff and training.
  • Define the supply strategy (timetable and priorities).
  • Set up a monitoring system for quantities distributed.

Public information
Heath promotion

  • To provide the public clear, practical information on the outbreak, patient care and if relevant, vaccination.
  • Determine:
    • message contents;
    • target audience;
    • means for transmission.
  • Provide support for health promotion (production of material, provision of staff, transport, etc.)

Vaccination

  • To quickly protect the at-risk population.
  • To limit the spread of the outbreak.
  • Decide whether or not to conduct a mass vaccination campaign.

If yes:

  • Define and prioritize the target populations.
  • Decide approach and planning of activities.
  • Validate ICG vaccine supply request.
  • Assess cold chain and storage capacity and needs.
  • Follow-up of vaccination implementation.
  • Determine timing of post-vaccination assessment (see Section 4.7.7).

Local committees

The other levels (regional and district) are involved in surveillance and alerts, data management, and response implementation.
They transmit information to the national level daily or weekly according to the phase of the outbreak.